Dr Patrick S Gillespie a Professional Medical Corporation
Organization Active NPI Legal Medicine · Washington, LA
NPI 1730406992 · NPPES record last updated Apr 28, 2010
Key facts
- NPI
- 1730406992
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Legal Medicine 173000000X
- Legal business name
- DR PATRICK S GILLESPIE A PROFESSIONAL MEDICAL CORPORATION
- Practice address
- 414 N Main St
Washington, LA 70589-4282 - Phone
- (337) 826-8044
- Fax
- (337) 826-8048
- NPI assigned
- Apr 28, 2010
- Organization subpart
- No
Authorized official
- Name
- Dr. Patrick Sean Gillespie, MD
- Title
- Owner
- Phone
- (337) 826-8044
Practitioners 1
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in LA
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20100510000205 | LA | Part B Supplier - Clinic/Group Practice | 1850429069 |
Receives reassigned benefits from 1 practitioner Practice locations: Washington, LA |
National Provider Directory
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Legal Medicine |
173000000X | Yes |
Addresses
Primary practice location
414 N Main St
Washington, LA 70589-4282
Mailing address
PO Box 698
Washington, LA 70589-0698
Phone (337) 826-8044
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1913677 | Medicaid | LA |
Other providers in Washington, LA
- Blaise F. Broussard
- Caring Hearts Medical Services
- CLHG-Ville Platte LLC
- Dixon Family Medical Center, LLC
- Dixon Family Medical Center, LLC
- Sadie Angelle Duos-Figueiredo
- Sarah L Edward
- Functional DME
- Patrick S Gillespie
- Glenn'S Family Pharmacy Inc
All providers in Washington, LA · Legal Medicine in Louisiana
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Apr 28, 2010. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.